Tailor-made Doses of Pharmaceuticals by Tunable Modular Design: a Case Study on Tapering Antidepressant Medication.

An abrupt cessation of antidepressant medication can be challenging due to the appearance of withdrawal symptoms. A slow hyperbolic tapering of an antidepressant, such as citalopram hydrobromide (CHB), can mitigate the withdrawal syndrome. However, there are no viable dosage forms on the market to implement the tapering scheme. A solution using a modular design approach to produce flexible and accurate doses of CHB is proposed. This design consists of two parts: (1) a module with a fixed amount of preloaded CHB in a freeze-dried polymer matrix, and (2) fine-tuning the CHB dose by inkjet printing. A non-contact food-grade printer, used for the first time for printing pharmaceuticals, is modified to allow for accurate printing of the highly concentrated CHB ink on the porous CHB-free or CHB-preloaded modules. The produced modules with submicron precision are bench-marked with commercially available CHB tablets that are manually divided. The proposed tunable modular design (TMD) covers the entire range of doses needed for the tapering (0.5-23.8 mg). The greatest variance is 13% and 88% when comparing TMD and self-tapering, respectively. Self-tapering is proven inaccurate and showcases the need for the TMD to make available accurate and personalized doses to wean off treatment with CHB. This article is protected by copyright. All rights reserved.